Community Pharmacy Scotland last month warned the country’s pharmacy network is in “serious financial trouble.” Things are not as rosy there as we might have believed, writes Neil Trainis…

The impression the community pharmacy sector in England has had for quite some time is that things are far rosier north of the border. Not so, it seems. England’s pharmacy network has long been told that its Scottish equivalent is valued much more by its government. “Scottish pharmacies are damn lucky to be well away from the magnetic field of this awful Tory government down south,” a pharmacist recently remarked to me. Time for a rethink, perhaps.

It seems the utopian Scottish landscape community pharmacy was bathing in was an optical illusion to England and the rest of the UK. If Community Pharmacy England has it tough, its Scottish counterpart is experiencing something similar.

At the last count, it had rejected two funding offers from the Scottish government, saying they fell “far short” of what is needed. “As pharmacy owners are increasingly turning to borrowing to keep their doors open, we are sounding the alarm,” Community Pharmacy Scotland exclaimed.

“Without an immediate and much-improved pay offer from (the) Scottish government, our members will be forced to control costs by cutting services to their patients – something no pharmacy owner wants to do.” 

It was a stark warning but, as has been the case in England, perhaps strong policy statements are what’s needed to force governments into constructive action. And the CPS went on. Individual pharmacy businesses, it said, could be forced to review free delivery services and medicines management support or even reduce opening hours to stay afloat.

And it went further. Even Scotland’s “world-leading” NHS Pharmacy First service could be at risk. Unless it’s properly funded, along with other national services, the CPS warned, it may have to be negotiated out of the contract.

“We will fight to avoid this outcome, but ultimately it is Scottish ministers who are in control of what care the people of Scotland can access from their pharmacies, and only an improved offer will secure the bright future we had planned for Pharmacy First,” it said.

There’s a brief backstory to the CPS-government clash. Funding concerns prompted the latter to provide an interim cash injection of £20 million over the remainder of 2023-24 to ease pressures related to medicines price increases on community pharmacy businesses.Unimpressed, CPS pointed out that the cost of medicines alone had gone up by at least three times that amount and rejected the offer.

“While £20 million appears to be a very big number, it represents only 1.74 per cent of the annual medicine spend for Scotland,” it said, insisting “negotiations must continue and a much improved offer must be forthcoming from government colleagues to ensure current service levels are maintained and access to healthcare is provided.”

Harry McQuillan, the CPS’ calmly spoken, philosophical chief executive, said he was “encouraged“ by the emergency injection of £20 million and assurances by the First Minister of Scotland Humza Yousaf to continue engaging with the CPS and “ensure pharmacies up and down the country are funded to the level they require.”

But McQuillan was in no mood to soft soap things and told the government bluntly that “we have a long way to go to an acceptable resolution. The action so far is insufficient to keep doors open and meet community healthcare needs.”

Pretty soon, inevitably, the Pharmacists’ Defence Association bounded into the dispute. And in typically brusque fashion, it accused the Scottish government of excluding representatives of employee pharmacists and other staff from its talks with CPS and urged ministers to include the union in those discussions.

The PDA insisted community pharmacy in Scotland would be better supported by tripartite talks between the government, CPS on behalf of pharmacy employers and the PDA, who would represent pharmacists including locums.

That £20 million, it said, had not “trickled down” to employees or other staff and it warned that although owning a pharmacy in Scotland is relatively attractive given the “apparent buoyancy of the market,” the wages of pharmacy employees had “stagnated for the last 15 years.”

The PDA also said the extra funding had not allowed owners to invest in more staff and training or improve their premises. Singling out Scotland’s cabinet secretary for health and social care Michael Matheson, the union called for “discussion and decision-making that listens to and balances the rights and responsibilities of both employers and workers” and urged him to ensure “tripartite discussions around all aspects of community pharmacy provision” take place.

The PDA did concede Scotland “provides the most generous community pharmacy settlement in the UK” but warned there are “unsuitable and sub-standard premises” in the country while employee pharmacists are “often told to undertake training unpaid during non-working hours.”

If may not be a stand-off of England proportions but the Scottish government has plenty to think about.

Let us know about your experiences in Scotland. Email neil.trainis@1530.com